About the UAMS Fellowship in Dermatopathology

History and Overview

The Dermatopathology Fellowship Training Program was established in July of 1997. The fully accredited program is a two year program, and is fully funded for one fellow. The training program is jointly sponsored by the departments of Dermatology and Pathology.

The fellowship program is designed to offer training in diagnostic dermatopathology with additional opportunities to conduct clinical and/or basic science research in dermatopathology. It is the primary goal of the fellowship training program to train applicants with an interest in pursuing a career in academic dermatopathology. Successful applicants are required to have completed training in either dermatology or pathology (anatomic, or anatomic/clinical) prior to initiation of training in dermatopathology. Six months of training in the opposite discipline are required for certification in dermatopathology. For pathologists, this goal is accomplished by having the trainees attend signout sessions in dermatopathology each afternoon, and dermatology clinics in the mornings. Generally, 1-2 half days per week are kept free for research endeavors. Dermatologists meet the goal of training in pathology by attending daily signout sessions in dermatopathology in the morning, and spend the afternoons cutting in surgical pathology specimens and attending surgical pathology signout sessions. For approximately two months, the trainees are on the autopsy pathology service. Attempts are made to design surgical pathology rotations in concert with the individual fellow's areas of interest. Again, schedules are devised with attempts to keep open 1-2 half days per week for research activities.

During the second year of the training program, fellows will assume a supervisory role during the daily signout sessions about one time per week. The remainder of the year will be spent pursuing research endeavors. It is expected that the fellow will undertake a basic science research project, in addition to several more clinically oriented projects.

There is no call or scheduled night-time responsibility in the program. However, it is expected that the fellows will preview each case prior to the next day's signouts and be prepared to discuss the findings.

The dermatopathology fellow plays an active role in conferences within both the Pathology and Dermatology departments. The Dermatopathology Unit gives a weekly "Chapters of Lever" conference around the microscope for the dermatology residents. In addition, there is a weekly informal microscope session at which time the best cases from the previous week are reviewed with the dermatology residents. The fellows are also urged to attend and occasionally to present at the conferences given by each department (selecting conferences that are of personal interest). A weekly consensus conference is held around a multi-headed microscope, at which time difficult cases from the prior week are discussed. Dermatology Grand Rounds occurs weekly and the fellow is expected to attend, and occasionally present the histologic findings of cases presented. Participation in regional Dermatology meetings such as Arkansas Dermatology Society is also encouraged.

The Dermatopathology Unit is a discrete division of the Pathology Department. It is directed by Dr. Bruce Smoller, who is also the director of the fellowship program. Dr. Smoller came to the University of Arkansas for Medical Sciences in 1997. He is a full-time dermatopathologist and has a joint appointment as a Professor in the departments of Pathology and Dermatology. His primary training is in pathology. Other faculty members in the Division include Dr. Thomas Horn, Professor and Chair, Department of Dermatology, who also came to the University of Arkansas for Medical Sciences in July 1997 and Dr. Glen Baker, Professor of Pathology, who has been a member of the faculty for many years. Dr. Horn is boarded in Dermatology and Dermatopathology and Dr. Baker is board certified in Anatomic and Clinical Pathology and Dermatopathology. The faculty will share signout responsibilities. The Dermatopathology Unit is primarily responsible for signing out all cases sent by the University Dermatology Department. This represents approximately 3000 biopsies per year. An additional 3000 cases per year done by the Department of Dermatology at the adjoining VA hospital are also signed out by the Dermatopathology Unit. Additional cases are reviewed from the surgical pathology service (which receives occasional cases from the departments of Surgery, Plastic Surgery and others) and from Arkansas Children’s Hospital. The Dermatopathology Unit is also reponsible for signing out all cases received in consultation by Dr. Smoller. The number of consultation cases is rapidly growing at this time and currently is approximately 4000 cases annually.

The Dermatopathology Unit operates an immunodermatopathology unit. Direct and indirect immunofluorescence procedures are performed daily. The fellows sign out these cases with Dr. Smoller on a daily basis, and are expected to become proficient in immunodermatopathology. Immunoperoxidase procedures are also incorporated into the Dermatopathology Unit. Fellows are encouraged to become familiar with the procedures. All immunoperoxidase preparations are reviewed during daily signout and ultimately signed out by the Dermatopathology Unit.

Occasional electron microscopic analyses of selected cases are performed in the pathology laboratory and reviewed under the supervision of Dr. Smoller.

Dermatopathology fellows are encouraged to become involved in original research projects. There are many members of the Departments of Pathology and Dermatology, as well as other researchers in the institution, who are available for collaborative efforts. In addition, there are always many clinicopathologic projects ongoing in the Dermatopathology Unit.

It is expected that fellows will attend the annual meeting of the American Society of Dermatopathology. Attendance at the annual meetings of the US-Canadian Academy of Pathology and the American Academy of Dermatology can also be arranged. Every attempt will be made to find travel monies for fellows who are presenting at these or any other meetings.

The Dermatopathology Unit is a program that is jointly supported by the departments of Pathology and Dermatology. The unit is physically located within the Pathology Laboratory, and is thus able to use all of the resources of the laboratory. Within the department and available for easy consultation are several nationally known pathologists: Dr. Aubrey Hough (rheumatologic pathology), Dr. James Waldron (hematopathology), Dr. Roby Thomas (soft tissue pathology), and Dr. Carla Wilson (hematopathology, molecular pathology). Trainees interact with these pathologists on a regular basis to discuss difficult cases.

The Dermatology Department is chaired by Dr. Thomas Horn,, whose main research interest is in cutaneous graft vs. host disease. Other members of the faculty include Dr. Sandra Johnson, whose major research interest is immunologic responses to human papilloma virus, Dr. Scott Dinehart (dermatologic surgery), Dr. Walter Hubert, a microbiologist interested in human papilloma virus and Dr. Jay Kincannon (pediatric dermatology). Pathologists will routinely rotate through clinics attended by the full-time Dermatology faculty. There is also a multidisciplinary Melanoma Clinic. On account of the large transplantation services from the hospital, there is a large volume of immunosuppression-related disease that is available for the trainees to learn from.

University of Arkansas Hospital is in Little Rock. It has approximately 450 beds and is attached to the Veterans Administration Hospital, which houses and additional 1100 beds. The hospital has a long history of national prominence in transplantation surgery and continues to have a large bone marrow transplantation program. Further, it serves as a tertiary care referral center for the entire state of Arkansas.

The Arkansas Childrens Hospital, which has approximately 250 beds, is located nearby and is also closely affiliated with the University Program. Residency training programs include routine rotations through the Children’s Hospital. The dermatopathology division sees difficult cases from ACH in consultation on a regular basis.

University of Arkansas for Medical Sciences is located in Little Rock. This small, capital city of about 175,00 people is the cultural center for Arkansas and provides a full range of cultural activities. The cost-of-living and pace of the city make it an especially easy place in which to live. The medical school/hospital complex is just west of the city center.

Financial support: Stipends for residents and fellows are competitive with other schools in the southern region. PGY-1 level stipend for 200-2001 is approximately $33,400.

Vacations: Residents/fellows receive 3 weeks (21 days, including weekends) of paid vacation each year (this cannot be "carried over" from one year to the next.

Professional Leave: Determined by the individual department. However, time spent attending professional meetings or taking board examinations or other examinations will not be counted as vacation if the activity is approved by the department.

Sick/Parental Leave: Residents/fellows have twelve days of leave for medical reasons during each year of training (cannot be "carried over"). Sick leave in excess of twelve days requires special review by the Assistant Dean and Program Director. Family Medical Leave (paid and unpaid) may be granted to care for a newborn child or seriously ill spouse, child or parent.

Health, Dental, Life, Disability and Professional Liability Insurances: provided for the resident.

Counseling/ psychological support services: The Employee Assistance Program (EAP) provides professional counseling and/or referral to community resources for a wide range of problems and situations including stres management, financial concerns, alcohol, and other drug abuse, elder care, job/career issues, parenting, legal issues, marital/family problems and personal/emotional concerns. UAMS has pre-paid the entire cost of the program so that the resident/fellow is not required to make any contribution within the EAP. However, if the resident/fellow is referred to a community resource, that person will be responsible for the cost.

Employee Health/Student Preventive Health Service: The clinic provides annual TB skin testing for all UAMS faculty and housestaff. It also provides the MMR vaccine, and chemoprophylaxis medications if indicated following blood or body fluid exposures.

Pre-employment Drug testing Policy: This policy will affect all incoming residents/fellows beginning in 1998-99. The VA Medical Center is instituting a random drug testing policy and ACH is developing a similar policy.

Computer facilities: All residents/fellows have access to several computer facilities at UAMS including the Learning Resource Centers in the main Library and Jeff Banks Dormitory and the Academic Computing Laboratory classroom in Education II building. Various computer classes are available.

Orientation: This is provided for all incoming residents and fellows at the end of June. The two-day orientation includes many important presentations about policies, teaching skills, ethics, cost containment and managed care issues, infection control, physician impairment, and employee benefits.

Annual Records: Residents/fellows must have a TB skin test yearly and complete a Confidential Health Questionnaire and an Incomplete Medical Records Statement.

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For more information about this web page, or about the programs at the UAMS Pathology department contact Renee' Gordon (gordonreneen@uams.edu )